The Disorder and Pathophysiology
The patient presents with signs and symptoms of rapid breathing, fruity smell breadth, and dehydration due to warm, flushed skin, drowsiness, unsteadiness, and thirst. The patient has also had vomiting, nausea, vomiting, fever, and diarrhea for three days. Based on the signs and symptoms, the disorder of the patient is type 1 diabetes mellitus. The patient also confirms the disorder by stating that she has type one diabetes. Her blood sugar levels on the glucometer also read high, which confirms that she has diabetes. Rapid breaths, drowsiness, fruity smell breaths, and unsteadiness mean that the patient is in a diabetic emergency, which should be managed immediately.
Diabetes Mellitus occurs as a result of less production of insulin or resistance to insulin by body cells. Insulin is a hormone produced by the beta cells of the pancreas. The main purpose of insulin is to control or regulate blood sugar levels (Dariya et al., 2019). In type one diabetes, the beta cells of the pancreas that produce insulin are destroyed, leading to low production of insulin or no production of insulin. The destruction of beta cells in the pancreas may be due to various factors, such as the attack of the pancreatic cells by the body’s immunity. Inflammation of the pancreas interferes with the normal function of the pancreas (Dariya et al., 2019). Destruction of the beta cells producing insulin means that the insulin level to regulate of control blood glucose levels is low or absent, leading to high glucose levels in the blood or body. High blood glucose levels in the blood or body lead to signs and symptoms of type one diabetes, such as increased thirst, vomiting, dehydration, rapid breaths, drowsiness, fruity smell breaths, confusion, and unsteadiness. In some cases, the pancreas may produce enough insulin, but the cells are resistant to the insulin, leading to type 2 diabetes. Type 1 diabetes is usually diagnosed in young people and children.
Etiology of Type One Diabetes
The primary cause of type one diabetes is the attack of the pancreas by the body’s immune system. The body’s immune system, which fights infection, may confuse pancreatic beta cells as foreign cells. The immunity, therefore, attacks the beta cells, which produce insulin, leading to inflammation and destruction of the cells (Dariya et al., 2019). Destruction of beta cells reduces the level of insulin produced to control glucose, leading to high glucose levels in the body. Genetic defects may lead to the destruction of pancreatic cells (Dariya et al., 2019). Environmental factors like exposure to radiation may alter genes, leading to type 1 diabetes (Yahaya & Salisu, 2021). Organisms such as certain viruses also may trigger type one diabetes.
Clinical Manifestations of Type One Diabetes
Clinical manifestations of type one diabetes help to diagnose the condition and may be general or emergency. General manifestations include polyuria, polydipsia, increased hunger, vomiting, dry mouth, weight loss even with eating, fatigue, Kussmaul respirations or heavy breathing, and blurred vision (Kahanovitz, Sluss & Russell, 2017). Vomiting may lead to dehydration, and polyuria may lead to bedwetting. The skin becomes warm and flashy. The mood of the patient may change. In emergency situations, clinical manifestations include confusion, rapid breaths, fruity smell breath, and loss of consciousness (Kahanovitz, Sluss & Russell, 2017). The patient may also complain of pain in the belly. Emergency situations should be addressed immediately to prevent complications or death.
Since the pancreas cells are destroyed, less insulin is produced, and the best treatment is to administer insulin to patients. Administration of either Short-acting, rapid-acting insulin, intermediate-acting insulin, or long-acting insulin controls the blood glucose levels (Kahanovitz, Sluss & Russell, 2017). The patient should, therefore, monitor the blood glucose levels. The artificial pancreas also helps in the treatment of type 1 diabetes by producing enough insulin for the body. Based on the risk factors for other conditions, the patient may be given high blood pressure medications such as ACE inhibitors and drugs for lowering cholesterol levels (Kahanovitz, Sluss & Russell, 2017). Non-pharmacological interventions include diet modification and performing some exercises.
Dariya, B., Chalikonda, G., Srivani, G., Alam, A., & Nagaraju, G. P. (2019). Pathophysiology, Etiology, Epidemiology of Type 1 Diabetes and Computational Approaches for Immune Targets and Therapy. Critical Reviews™ in Immunology, 39(4).
Kahanovitz, L., Sluss, P. M., & Russell, S. J. (2017). Type 1 diabetes–a clinical perspective. Point of care, 16(1), 37.
Yahaya, T., & Salisu, T. (2021). Genes predisposing to type 1 diabetes mellitus and pathophysiology: a narrative review. arXiv preprint arXiv:2101.06680.
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Using the case study below, prepare a 2 – 3-page paper.
A 21-year-old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room, you note that she’s unsteady, her skin is warm and flushed, and she’s drowsy. You also note that she’s breathing rapidly and smells a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.
You get more information from A.M. and learn the following:
She had some readings on her glucometer, which were reading ‘high’
She vomits almost every time she takes in fluid
She hasn’t voided for a day but voided a great deal the day before
She’s been sleeping long hours and finally woke up this morning and decided to seek care
Current labs and vital signs:
What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
Describe the etiology of the disorder A.M. is experiencing.
Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.
Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition.
Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.
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